Referral hospitals

Newmarket sits on the Cambridgeshire/Suffolk border, more or less half way between Cambridge (12 miles to the west) and Bury St Edmunds (a similar distance in Suffolk to the east). Today’s Newmarket medics refer patients in both directions, i.e. Addenbrooke’s in Cambridge and the West Suffolk Hospital in Bury St Edmunds. Historically referral was much less common than it is today, but did happen, and reflects the same pattern. The earliest hospital used for referrals mentioned in the Newmarket historical records is Addenbrooke’s, in 1830. The earliest example of a consultant opinion comes from the other direction in 1839, involving Dr Probart, a physician from the West Suffolk General Hospital in Bury St Edmunds.

Addenbrooke’s Hospital in Cambridge was named after John Addenbrooke, one of those historically rare University educated physicians (see The history of medical treatments, training, qualifications and regulation). On his death in 1719 he left money towards a small hospital for the poor in Cambridge. After quite some time the hospital eventually opened in 1766, in Trumpington Street. Ongoing funding came from charitable donations and subscribers, who could refer patients in. St Mary’s parish in Newmarket was a subscriber in the 1830s (perhaps before that as well), and later the Newmarket Union took on a similar role well into the 20th century (see the page on the Newmarket Union for further details, and some key/interesting references below). Starting with a modest plan of at least 20 beds, by 1866 Addenbrooke’s had 120 beds. In 1962 this Old Addenbrooke’s, as it became known, spawned the New Addenbrooke’s on the southern outskirts of Cambridge, a site which has increasingly been developed ever since. It’s of note that in the second half of the 20th century Addenbrooke’s based consultants also worked at Newmarket Hospital (and vice versa); even today Newmarket Hospital holds outpatient clinics served by Addenbrooke’s consultants.

The West Suffolk General Hospital in Bury St Edmunds (also known as the Suffolk General Hospital), opened in 1826 in what presumably subsequently became known as Hospital Road. It appears to have been regularly referred to as either the West Suffolk Hospital or West Suffolk General Hospital from 1836 onwards, after the establishment of the East Suffolk Hospital in Ipswich that year. However, its official name in the Medical Directory remained the Suffolk General Hospital until 1905, and both names seem to have been used even after that (e.g. 1921 below). Like Addenbrooke’s above it was funded by subscription / charitable donations, and the Newmarket Union subscribed. From a Newmarket medical history point of view it’s of particular interest that Robert James Peck’s assistant Francis Charles Pyman became the resident Apothecary and Secretary in 1828. Richard Faircloth tried to succeed him unsuccessfully in 1833 as apothecary and surgeon (if he’d been successful it might have had profound effects on how the subsequent medical history of Newmarket unfolded, to this day – see the page on Richard Faircloth for why). Also, Robert Peck’s business partner Andrew Ross became a physician to the Suffolk General Hospital in 1839, after he’d left Newmarket. Three Newmarket medics (Frederick Page, Robert James Peck, and Richard Faircloth) attended an early operation under ether anaesthetic there in 1847 (click here for a fascinating report from that event). The hospital moved to its current Hardwick Lane location in 1973. As with Addenbrooke’s above, in the second half of the 20th century consultants based at the West Suffolk Hospital also worked at Newmarket Hospital (and vice versa), and even today Newmarket Hospital holds outpatient clinics served by West Suffolk consultants. (As with Addenbrooke’s above, see a collection of key/interesting references below).

The ayslums historically serving the population of Newmarket were at Melton in Suffolk and Fulbourn in Cambridgeshire, opening in 1829 and 1858 respectively. There was also an institution near Colchester that focused on learning disability, which opened in the 1850s. Many patients were sent to the London asylums before these more local ones opened, and of course many were managed in Newmarket too. Most of the records relating to these types of case (and the associated institutions) are in the Newmarket Union records – see the section on psychiatric cases on the page about that institution for more details, and a few key references below.

Other referral hospitals that have historical links with Newmarket are also covered on the page about the Newmarket Union, including some in London, and there’s also a paragraph about the local TB sanatoria in Nayland Suffolk and Papworth Cambridgeshire, which opened in 1901 and 1917/18 respectively. Again some key interesting references are included below as well.

Relevant references in chronological order

1826, 15th July: Under the heading ‘Suffolk Hospital’ ‘A General Board of Governors of this Institution was held on Saturday last… since its opening in January last… 20 at present in the Hospital… eight operations have been performed…’ Reference: The Bury and Norwich Post. Wednesday Jul 19 1826: 2.

1828, October: Francis Charles Pyman’s application for the post of Apothecary and Secretary to the Suffolk General Hospital was published in the Newspaper, with references, including from the Newmarket medics Robert James Peck, W Norton, J Taylor and Henry Kendall. Reference: The Bury and Norwich Post. Wednesday Oct 22 1828: 3. [Note: the reference from Robert James Peck reads ‘To the Governors of the Suffolk General Hospital. My Lords, Ladies, and Gentlemen,- I have sincere plea-sure in offering my testimony to the fitness of Mr. F. C. Pyman for the situation of Apothecary and Secretary to the Suffolk Hospital. During his residence of fourteen months with me as an assistant, I have had opportunities of judging of his professional talents, and I assure you that they are of the very highest order. His opportunities of seeing Hospital Practice have been great, and he has not lost sight of them. From his well-grounded knowledge in anatomy, and his ex-tensive medical reading, his zeal in acquiring professional in-formation during his studies must have been unwearied.- From his general conduct during his residence with me, I feel confident that he will most conscientiously, skilfully, and kindly execute the very important office he so earnestly solicits. I have also to add that his moral conduct is unexceptionable. I am, my Lords, Ladies, and Gentlemen, your obedient humble servant, ROBERT JAMES PECK, Surgeon. Newmarket, Oct.2d.’], [Note also, he got the job. Reference: The Suffolk Chronicle. Wednesday Oct 25 1828: 3, but resigned in 1833 to join the India Service. Reference: The Bury and Norwich Post. Wednesday Jan 16 1833: 3.]

1830, 9th November: The Newmarket St Mary’s parish vestry book churchwarden’s accounts for 1830-1831 show a ‘one year subscription to addenbrookes [sic] Hospital’ for £2 and 2 shillings. Reference: FL610/1/2a, (Suffolk County Record Office, Bury St Edmunds). [Note. this is also shown the following year.]

1833, 4th February: Mr Richard Faircloth was one of five ‘Candidates for the Vacant Office of House Apo-thecary and Surgeon’ at the Suffolk General Hospital in Bury St Edmunds. Reference: The Bury and Norwich Post. Wednesday Feb 6 1833: 3. [Note: in the event, one of the other candidates was appointed, i.e. Mr. William Ward; see the page on Richard Faircloth for more details.]

1836, 8th April: ‘WEST SUFFOLK GENERAL HOSPITAL.– … the annual re-sources from subscriptions and dividends fall short of expenditure… a further decrease may be expected from the establishment of the Hospital at Ipswich.’ Reference: The Suffolk Chronicle. Saturday Apr 9 1836: 2.

1836, 4th June: ‘EAST SUFFOLK HOSPITAL / The Provisional Committee of managers re-quest the Subscribers pay their First Annual Sub-scription… a General Meeting of the Subscribers will be held at Ipswich, at the Hospital, on Friday, the 8th of July’. Reference: The Suffolk Chronicle. Saturday Jun 4 1836: 2.

1836, 12th October: An advert in the press: ‘JUST PUBLISHED… A NEW EDITION of the GUIDE to the TOWN, ABBEY, and ANTIQUITIES of BURY ST. EDMUNDS… Statement of the West Suffolk Hospital…’ Reference: The Bury and Norwich Post. Wednesday Oct 12 1836: 2. [Note: the same page has an advert with the heading ‘Suffolk General Hospital’ about an anniversary meeting (presumably the 10th anniversary).]

1836, 21st October: ‘a letter from the Secretary to Addenbrookes [sic] Hospital offering to receive 1 inpatient and 2 outpatients for every Guinea subscribed by the Union for the year’. Reference: 611/11, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds).

1837, 21st November: ‘Ordered that the question relative to the Subscription to a Hospital be taken into consideration on the 5th of December and that the Clerk in the meantime write to the Secretary of the Suffolk Hospital for the terms of admission’. Reference: 611/12, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds).

1837, 5th December: ‘Resolved that the sum of 14 Guineas be subscribed to the Cambridge Hospital and 6 Guineas to the Suffolk Hospital’. Reference: 611/12, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds).

1839, 6th February: ‘On Wednesday last Dr. Ross was unanimously elected one of the Physicians to the Suffolk General Hospital, in this town, in the room of Dr. Bayne, resigned’. Reference: The Bury and Norwich Post. Wednesday  Feb 13 1839: 2. [Note: see the page on Andrew Ross for how we know this was him.]

1839, 21st May: The Newmarket Union minutes mention a ‘Report of Doctor Probart of Bury St Edmunds M.D. upon the causes of the Sickness in the House [i.e. workhouse] and the proposed Remedies’ (which unfortunately it does not record) followed by ‘A check [sic] upon the treasurer… was drawn in favour of Mr Richd Faircloth for the fee paid by him to Dr. Probart for his attendance and Report’. Reference: 611/12, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds).

1845, 11th February: The medical officer reported that someone ‘an Inmate of the House was a dangerous Lunatic, the Board directed him to be forthwith removed to the Suffolk Lunatic Asylum at Melton’. Reference: 611/16, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1851, 7th November: ‘a patient in the Hospital of the Workhouse, suffering from fistula’ was transferred ‘to the Institution in Lower Bentley Street, London for the treatment of that disease, and also’ another ‘patient in the Hospital suffering from an affection of the eyes’ was transferred ‘to the Opthalmic [sic] Hospital, Westminster’. Reference: 611/19, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: in 1891 (10th November) another patient was sent to St Mark’s Hospital, London, for a fistula operation (611/34), but interestingly after medical assessment and before the operation he was sent ‘to the Convalescent Home at Worthing to recruit his strength before being operated upon.’ 2nd February 1892 minutes (611/34).]

1858, 11th June: ‘A Cheque for £2..2..0 was given… to “The Royal London Ophthalmic Hospital” being one year’s subscription to the Hospital’. Reference: 611/21, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: there were later subscriptions to this hospital too.]

1858, 19th November: ‘Orders of Removal of certain Lunatics from the Metropolitan Asylums to the County Lunatic Asylum having been laid before the Board William Fletcher Relieving Officer was directed to execute the same forthwith’. Reference: 611/22, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: this was when the Fulbourn asylum opened, before this many Cambridgeshire patients were managed in London asylums.]

1859, 2nd December: Expenses incurred by the parish of Dullingham for transporting a patient ‘to and from the Orthopaedic Hospital London’ mentioned in the Newmarket Union minutes. Reference: 611/22, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: there was later reference in 1866 to a patient from Gazeley being maintained in ‘the National Orthopaedic Hospital, Great Portland Street, Regents park, London’ (7th August – 611/25), but see also 1867 below.]

1866: The medical Directory records Addenbrooke’s Hospital with 120 beds, three physicians, three surgeons and one resident house surgeon/apothecary. Reference: The Medical Directory. London: Churchill; 1866. [Note: at this point the Suffolk General Hospital had 84 beds, one physician, one surgeon defined as a consultant, and three others surgeons listed, plus a house surgeon (this bed number might be inaccurate, since it’s modified to 64 in 1902 – see 1904/5 below) – it increases again to 80 in 1913.]

1867, 19th February: Dr Mead (Medical Officer for District 3) recommended that two children from Ashley ‘suffering from spinal disease’ be ‘removed’ (i.e. referred) to the ‘National Orthopaedic Hospital Great Portland St., Regents Park, London’ and ‘the clerk was directed to ascertain from the secretary of the hospital, in the event of their removal, the cost of their maintenance there and any other information requisite for procuring their admission as in-patient’ (but Dr Gray stepped in – see 19th March below). Reference: 611/25, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1867, 19th March: The cases of the two children from Ashley ‘suffering from spinal affection’ were again discussed (see 19th February above). ‘A letter from Dr. Gray of Newmarket was read stating that instruments are necessary and generously offering to undertake the charge of both cases and give his assistance gratuitously’. Instruments were provided by the Parish of Ashley for one case and the Newmarket Union for the other. Reference: 611/25, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1873, 13th May: A letter from the secretary Addenbrookes Hospital Cambridge was read intimating that as great trouble is experienced at the Hospital by Patients coming unprovided with change of linen and money to pay for washing it in future no patient can be admitted unless the rule to that effect be complied with; and that the money (1s/- per week) for that purpose on account of Pauper Patients is expected to be sent without any application. A copy thereof was ordered to be handed to each Relieving Officer’. Reference: 611/28, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1887, 1st November: The guardians provided a loan to a hurdlemaker from Kirtling ‘for providing an out-fit of clothing for his daughter preparatory to being admitted into the Essex Hall Asylum for Idiots at Colchester’. Reference: 611/33, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: see the page on the Newmarket Union for an explanation of this alarming terminology; the institution was otherwise known as ‘the Eastern Counties Asylum for Idiots’ mentioned in a letter minuted on 24th July 1888 (611/33) which described ‘the training and instruction provided for Idiots and Imbeciles’ that they offered. Later in the minutes they appear to have been called ‘the Royal Eastern Counties Institu-tion’ (14th June 1927 (611/46).]

1889, 14th May: ‘A letter from the Secretary of Addenbrooke’s Hospital Cambridge calling the attention of the Board to Rule 82 which enacts “That each patient shall be required to pay 1s/-d a week for tea and other small necessaries” and requesting that this allowance be made by the Board on behalf of… a patient in that Hospital admitted from the Workhouse of this Union.’ Reference: 611/33, Newmarket Union Minutes, (Suffolk County Record Office, Bury St Edmunds).

1904: ‘BURY ST. EDMUNDS.– SUFFOLK GENERAL HOSPITAL. Founded 1825. 64 beds…’ Reference: The Medical Directory. London: Churchill; 1904. [Note: at this point Addenbrooke’s had 174 beds.], [Note also: the hospital in Ipswich is referred to as the ‘EAST SUFFOLK AND IPSWICH HOSPITAL’.]

1905: ‘BURY ST. EDMUNDS.– WEST SUFFOLK GENERAL HOS-PITAL. Founded 1825. 64 beds…’ Reference: The Medical Directory. London: Churchill; 1905. [Note: at this point Addenbrooke’s had 174 beds.], [Note also: the hospital in Ipswich is still referred to as the ‘EAST SUFFOLK AND IPSWICH HOSPITAL’.]

1913, 28th January: ‘It was resolved on the recommendation of the medical officer that… an inmate of the workhouse be sent to Addenbrookes [sic] Hospital for treat-ment’. Reference: 611/42, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: there were other similar examples in the minutes.]

1921, 20th September: ‘A letter was read from the Cambridgeshire County Tubercul-osis Officer… stating that only 100 beds are provided for cases suffering from tuberculosis for the whole county…’. Reference: 611/44, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: see 1928 below also.]

1921, 11th October: The list of annual subscriptions paid by the Guardians included £10, 10 shillings to Addenbrooke’s Hospital and £2, 2 shillings to the Suffolk General Hospital. Reference: 611/44, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1925, 6th October: ‘A letter was read from Addenbrookes [sic] Hospital making a special appeal for contributions towards the heavy and increasing expenses of the Hospital when such letter was referred to the Finance Committee’. Reference: 611/46, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: the 3rd November minutes record that the ‘committee considered the application from Cambs. Addenbrookes [sic] Hospital for an additional subscription towards the funds of the Hospital when it was resol-ved to defer this application until a later date…’]

1926, 23rd March: ‘An application was received from [someone] of Exning with regard to the cost of the Ambulance for conveying (under the medical officer’s direction) the late [patient] who was in receipt of relief to the Addenbrookes Hospital… when it was resolved that this charge be paid by the Guardians’. Reference: 611/46, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1926, 20th April: ‘It was resolved that a girl who is now in the work-house be sent to the Skin Disease Hospital, in London [sic] for medical treatment and that the master be authorised to arrange for this.’ Reference: 611/46, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds).

1928, 24th January:Dr Maund medical officer of the Institution’ reported on a case recently admitted there ‘at the request of Dr Paton Philip the Cambs. County Tuberculosis officer’ that ‘sanatorium treat-ment may be beneficial to her… when it was resolved that steps be taken to obtain the ad-mission of this case to the Nayland Sanatorium for such time as may be necessary.’ Reference: DC1/4/1, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: Nayland is about 30 miles south-east of Newmarket. The East Anglian Sanatorium opened there in 1901, run by a Dr June Walker, for the open air treatment of patients with TB. Reference: Sparrow, W, Carver A. Nayland & Wiston 1860s – 1950s. A portrait in photographs. Nayland with Wissington Conservation Society; 2002 (this book is composed of images with brief notes, with images 71-76 of the sanatorium, including pictures of its farm and gardens).]

1928, 10th July: ‘A letter was received from the Papworth Village Settlement’ regarding the charges for admitting patients there. Reference: DC1.4.1, Newmarket Union minutes, (Suffolk County Record Office, Bury St Edmunds). [Note: Papworth Hospital began as a place for treating tuberculosis in 1917/18. Reference: https://www.papworthtrust.org.uk/about-us/our-history/ (accessed 18th September 2018).]

Some other sources consulted include:-

Children’s Homes. Eastern Counties Asylum for Idiots and Imbeciles / Royal Eastern Counties Institution for the Mentally Defective, Colchester, Essex. http://www.childrenshomes.org.uk/ColchesterMD/ (accessed 23rd October 2018). [Note: see the relevant section on the page on the Newmarket Union regarding this alarming terminology.]

Cockayne EE, Stow NJ. Stutter’s Casebook, A junior hospital doctor, 1839-1841. Woodbridge, Suffolk: The Boydell Press, Suffolk Records Society volume XLVIII; 2005. (General introduction, pg xvi-xix, includes mention of Dr Probart, and a more detailed biography of him can be found on pg 101-2.)

County Asylums. Fulbourn. https://www.countyasylums.co.uk/fulbourn-cambridge/ and St. Audrey’s. https://www.countyasylums.co.uk/st-audrys-hospital-woodbridge/ (accessed 23rd October 2018).

Munk W. The roll of the Royal College of Physicians… Vol. II, 1701 to 1800. London: The Royal College of Physicians; 1878.

Rook A, Carlton M, Cannon WG. The history of Addenbrooke’s Hospital, Cambridge. Cambridge: Cambridge University Press; 1991.

Suffolk Medical Biographies. Profile for Probart, Dr. Francis George, JP http://www.suffolkmedicalbiographies.co.uk/Profile.asp?Key=2305 (originally accessed 22nd October 2018, when this website did not have the 1839 Newmarket Union reference). [Note: see comments regarding this website on the Francis Greene page.]

The Medical Directory. London: Churchill. [Note: this publication has been known by various titles over the years. Initially it just covered London, but from 1847 it had a wider remit, being variously known as the London and Provincial Medical Directory, The Medical Directories, The Medical Directory, etc., essentially the same work with minor variations and developments. It is usually referred to as The Medical Directory (as opposed to The Medical Register), so that is how it’s consistently referred to on talkingdust.net.]

The National Archives, Hospital Records Database. West Suffolk Hospital, Bury St Edmunds. http://www.nationalarchives.gov.uk/hospitalrecords/details.asp?id=541 (accessed 23rd October 2018).

Note: For published material referenced on this website see the ‘Acknowledgements for resources of published material’ section on the ‘Usage &c.’ page. The sources used for original unpublished documents are noted after each individual reference. Any census records are referenced directly to The National Archives, since images of these are so ubiquitous on microfilm and as digital images that they almost function like published works. Census records are covered by the ‘Open Government Licence’ as should be other such public records (see the ‘Copyright and related issues’ section on the ‘Usage &c.’ page for which references constitute public records, and any other copyright issues more generally such as fair dealing/use etc.).